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Conducting an interview
Abstract
The traditional guidance to researchers conducting interviews in the field is that the researcher should say as little as possible and encourage the respondents to talk in an untramelled way about the issues under discussion. But is this approach appropriate in all circumstances ? Keith Melia examines the issues by focusing on research carried out in an intensive care unit.
... The main researcher carried out the analysis (R.A). Author (AS) served as a 'critical observer/ friend ' [24,25], reflecting on and challenging explanations as they arose in respect to the data. ...
Background
Narrative master plots identify illness stories which are recognisable within clinical settings. Responses to different master plots by physiotherapy students can lack empathy and need to be understood further. One narrative master plot for people with stroke that has not been well studied is called ‘overcoming the monster’. Research is needed to understand physiotherapy students’ reactions to this master plot.
Objective
To examine the responses of physiotherapy students to three variations of the master plot called ‘overcoming the monster’ generated from patients who have had a stroke.
Methods
A qualitative narrative vignette study was undertaken. A university in the West Midlands (England) was used to access physiotherapy students on the pre-registration programs. A purposive sample of students volunteered to complete a single vignette questionnaire at one time point. The vignette provided three unique examples of the master plot overcoming the monster as told by people with stroke. Students responded to each by asking specific questions that captured demographic information and questions that captured reactions to the different versions of the master plot. Categorical-content narrative analysis was undertaken.
Results
Thirty-two first year (BSc) students, thirty-nine first year (pre-registration) MSc students and nineteen third year (BSc) students participated in this study. Neither first year groups had undertaken any clinical placement hours. All third-year students had finished the required clinical placement hours for the physiotherapy course. Students consistently demonstrated empathy towards this master plot. Students often valued the variant of the story which illustrated how difficulties following stroke could be experienced as an ‘adventure’. Students also valued and were motivated by the story variant that considered a family member as a source of motivation and encouragement. The story variant which focused on the shortcomings of the health care system was more often related to by the final year BSc students and MSc students. However, first year students, particularly BSc students, reported being more emotionally affected by the vignette.
Conclusion
All variants of the master plot overcoming the monster appeared to generate empathetic responses. This is important because it highlights the value of students’ understanding the patients’ story and challenges or ‘monsters’ faced. Therapeutic relationships will benefit from training physiotherapy students on the importance of listening and exploring challenges people with stroke face.
... The main researcher carried out the analysis (R.A). Author (AS) served as a 'critical observer/ friend ' (23,24), re ecting on and challenging explanations as they arose in respect to the data. Responses to each variation of the stories Story A: the monster is identi ed through the challenges created by the Stroke and references mental health di culties. ...
Background
Research is needed that considers student health care professional (HCP) reactions to different stories of illness. Master plots identify illness stories which are recognisable within particular settings. One master plot for people with stroke that has not been well studied is called ‘overcoming the monster’. Students reactions to such a plot are important as a way to enhance therapeutic interactions.
Objective
To examine the responses of physiotherapy students to three variations of master plot called ‘overcoming the monster’ generated from patients who have had a stroke.
Methods
A qualitative narrative vignette study was undertaken. A university in the West Midlands was used to access physiotherapy students on the pre-registration programs. A purposive sample of students volunteered to complete a single vignette questionnaire at one time point. The vignette provided three unique examples of the master plot overcoming the monster as told by people with stroke. Students responded to each by asking specific questions that captured demographic information and questions that captured reactions to the different versions of the master plot. Categorical content-analysis was undertaken.
Results
Thirty-two first year (BSc) students, thirty-nine first year (pre-registration) MSc students and nineteen third year (BSc) students participated in this study. Neither first year groups had undertaken any clinical training. All third-year students had finished the required clinical placement hours for the physiotherapy course. Students consistently demonstrated empathy towards this master plot. Students often valued the variant of the story which illustrated how difficulties following stroke could be experienced as an ‘adventure’. Students also valued and were motivated by the story variant that considered a family member as a source of motivation and encouragement. The story variant which focused on the shortcomings of the health care system was more often related to by the final year BSc students and MSc students. However, first year students, particularly BSc students, reported being more emotionally affected by the vignette.
Conclusion
Overcoming the monster is a master plot which appears to generate more empathetic responses compared to other master plots. This is important because it highlights the value of students understanding the patients’ story and challenges or ‘monsters’ faced. Therapeutic relationships will benefit from training HCP students on the importance of listening, exploring and reflecting on the different master plots they may hear in practice.
... This type of interview has flexible questions but still follows a guidance of topic boundary. It allows researchers, who already have moderate understanding about the topic through personal reflection and literature review, to maintain the control over the interview (Melia, 2000;Whiting, 2008;Merriam and Tisdell, 2016:111). With semi-structured style, the researcher can narrow the interview topic to a specific area, but still set an equal role with interviewees to adopt new thoughts and feelings. ...
This paper aims to explore potential issues in implementing peer-to-peer recognition to motivate employees. A qualitative inquiry is applied to enhance our understanding of peer-to-peer recognition schemes in practical situations. Sixteen participants, including HR researchers and managers from different organizations where this program has been implemented, attended semi-structured interviews. From which twelve cases are chosen for this study. Using thematic analysis on the collected responses, the researcher finds that challenges to peer-to-peer recognition are to be found in four categories: the impact of personal relationship, the unsuitability of working climate, the confusing nomination criteria, and the lack of an appropriate rewarding policy. Practical solutions to deal with those challenges are also proposed, which include building the culture and assigning monitor, to assist employers to effectively make use of a peer-to-peer program in motivating employees. This study therefore raises the awareness of optimizing motivation program for HR practitioners, as well as contributes a qualitative approach toward the non-cash recognition evaluation.
... The interview was conducted in two parts which are discussed below, where brief instructions and open-ended questions were given. Melia supports the notion that the interviewer ensures control is maintained but contributes little else but asking questions 145 . ...
This research study looks at how Community Musicians use nonverbal communication in their natural workshop settings in a series of observations across three individual case studies. A mixed-methods approach is used within a case study methodology, drawing upon observation, semi-structured interview, and repertory grid techniques. Computer assisted thematic analysis drew these data sources together using adapted grounded theory approaches alongside a theoretical framework based on kinesics, proxemics, and haptics.
Results indicate that two categories of kinesics (illustrators and affect displays) are heavily used by Community Musicians, typically with the purpose of either musical gestures or immediacy. Interlinking cues and purposes also suggested that several nonverbal cues were used together to create particular effects. Most nonverbal communication also appeared to be used subconsciously, reflecting the natural use of tacitly held knowledge. However, some awareness of nonverbal communication was crucial to avoid over-use or for adapting to the needs of certain contexts. This was particularly the case regarding haptics and proxemics.
The study concludes that Community Musicians’ use of nonverbal communication is interwoven into accessible music-making and the social aims of workshops. The study also found that being more aware of nonverbal communication requires looking beyond kinesics to consider the range of cues a Community Musician will use, including posture and haptics. Finally, while reflection on the use of nonverbal communication is helpful, looking at each Community Musician’s construct-building highlighted the need to preserve some of the spontaneous use of nonverbal communication due to the need for
genuineness in Community Music practice.
... However, authors such as Oakley (1981), state that trying to control the interview process does not respect the role of participants and treats them as if they are there just waiting to produce data. Melia (2000) recalls developing a more giving approach while interviewing nurses in the intensive care environment. Personal reflection, aided by a literature review on interviewing within and outside the nursing profession, will enhance understanding of the fundamental issues and enable researchers to question their practice and develop a personal philosophical approach to interviewing. ...
Nurses are increasingly involved in research, particularly qualitative research. This article aims to prepare nurses for conducting semi-structured research interviews.
... Their role was to consider the analysis in relationship to the transcribed data, acting as 'critical friends' [42,43]. Each author reviewed two interview scripts and considered how these related to the thematic development and commented on the appropriateness of the theme, and also considered whether themes had been overlooked [44]. ...
Background
The use and value of different complementary therapies requires investigation. In particular, qualitative research is required to understand the perceptions and experiences of patients who undergoing healing therapy as one type of complementary therapy. The aim of this research is to consider patients perceptions and experiences following a course of healing therapy.
Methods
Twenty two patients took part in this study. This included 13 patients with irritable bowel disease (3 male, 10 female, 47.6 ± 15.0 years), 6 patients with ulcerative colitis (3 male, 3 female, 48.5 ± 25.6 years) and 3 female patients with Crohn‟s Disease (45.0 ± 5.2 years). Each patient undertook a single semi-structured interview following a course of healing therapy. The data was analysed using a thematic analysis.
Results
Three broad themes were identified from patient interviews (1) The understanding and expectation of healing (2) Experiences and reflection on healing (3) Impact and outcome of healing. The details of each theme are explored within the text, revealing often an individual experience to healing therapy.
Conclusion
Patients were open towards the benefits that could be attained by healing, although most patients were not sure what healing would entail. Some patients expected to be relaxed by the sessions. However, the most consistent reports were that patients experienced a relaxing sensation that was generated within the session and lasted for a time period after the sessions. In addition to this the healing appeared to be associated with patients feeling more tolerant of their symptoms. Patients valued the therapist and their input into the healing process. It should be noted however, that this report cannot consider the efficacy of the treatment. Further details and experiences are considered within the article, including one negative experience.
... Thematic analysis was undertaken by the primary author, with a co-investigator (AS) acting as a critical friend [20,21]. Analysis commenced once data collection was underway, using empirical data driven codes in an inductive process. ...
Long delays from symptom onset to the diagnosis of occupational asthma have been reported in the UK, Europe and Canada and workers are often reluctant to seek medical help or workplace solutions for their symptoms. Reducing this delay could improve workers' quality of life, and reduce the societal cost of occupational asthma. This study aimed to explore reasons behind such delays.
A purposive sample of 20 individuals diagnosed with, or under investigation for, occupational asthma (median age = 52; 70% male; 80% white British) undertook a single semi-structured interview. Interviews were transcribed verbatim and thematic analysis was undertaken in order to explore health beliefs and identify barriers to diagnosis.
Four themes were identified: (1) workers' understanding of symptoms, (2) working relationships, (3) workers' course of action and (4) workers' negotiation with healthcare professionals. Understanding of symptoms varied between individuals, from a lack of insight into the onset, pattern and nature of symptoms, through to misunderstanding of what they represented, or ignorance of the existence of asthma as a disease entity. Workers described reluctance to discuss health issues with managers and peers, through fear of job loss and a perceived lack of ability to find a solution. The evolution of workers' understanding depended upon how actively they looked to define symptoms or seek a solution. Proactive workers were motivated to seek authoritative help and negotiate inadequate healthcare encounters with GPs.
Understanding workers' health beliefs will enable policy makers and clinicians to develop better workplace interventions that may aid diagnosis and reduce delay in identifying occupational asthma.
Copyright © 2015 Elsevier Ltd. All rights reserved.
... Trustworthiness [23,24] of the data was considered on several fronts. Triangulation was performed in different ways: Author BS acted as a " critical friend " [25,26] during the analysis and following analysis a defendable case was presented to author HD. An initial coding scheme was developed (an audit trail is obtainable from the corresponding author). ...
To understand how patients with Multiple Sclerosis experience and express hope within a rehabilitation setting and use this information to help therapists in a clinical setting.
One guided interview was undertaken.
Two locations were used for interviews: (1) a rehabilitation centre in Oxfordshire. (2) A meeting location for the MS society in London.
Eleven patients with Multiple Sclerosis were selected (54.5±8.8 years). Six patients were classified as being in the secondary progressive stage and 5 were classified as relapsing remitting phase.
The patients selected were part of a 12-week Multiple Sclerosis rehabilitation program. One interview took place mid way through the rehabilitation program and immediately following the end of the rehabilitation program. The semi-structured interview comprised of 5 sub-sections. Categorical content analysis was used to analyse the results.
Three main themes were identified that related to the paradox of chronic illness: (1) defiance and the patient (2) accepting the diagnosis and prognosis and (3) accepting deterioration. These themes provide a basis for the different types of hopes expressed by patients.
It is vital to understand the paradox of chronic illness as an expression common among patients with Multiple Sclerosis. This research illustrates the importance of listening to a patient's narrative during rehabilitation.
... This was to confirm integrity in the analysis and consider alternative explanations. Emerging findings were presented on a regular basis to AS, who as an experienced qualitative researcher acted as a " critical friend " [15,16]. Finally during the initial stage a coding scheme was developed and an audit trail was used to document this. ...
There is a high prevalence of Lower Back Pain (LBP) within military populations. Physiotherapeutic management has a primary role for patient care, but there is a need to establish the most effective management. Civilian physiotherapists provide the majority of clinical provision throughout the Defence Medical Rehabilitation Programme for British Armed Forces personnel. To date no study has been carried out looking at their perceptions and beliefs with regards to management of non-specific LBP and the potential impact this had on the delivery of rehabilitation across Defence.
This mixed methods exploratory study aimed to explore the potential complexities surrounding the decision making process with regards to management of non-specific LBP using semi-structured interviews with 14 MOD civilian physiotherapists. All interviews were transcribed verbatim. The transcribed data was then subjected to a categorical content analysis.
The analysis of the interview data revealed four interrelated themes that influence civilian physiotherapists in their management of back pain in military personnel: the military environment, integration of military procedures, physiotherapist treatment approach and communication.
This paper highlights the value civilian physiotherapists place on experience when managing non-specific LBP. This experience however was gained through 'patient mileage' rather than integration of best evidence into practice. Several problems were identified in patient management including specific types of patients and their expectations and the importance of the right communication between Health Care Professionals, but also with patients.
... Analysis was conducted by the lead researcher (AS). BS acted as a 'critical friend' [24,25], providing reflection and questioning explanations as they emerged in relation to the data. ...
To consider physiotherapy students' responses to three illness narratives common in rugby players who have suffered a spinal cord injury (SCI).
A narrative vignette was provided to first and third year students reading for a Batchelor of Science degree in physiotherapy.
A university in the West Midlands during a year cohort meeting.
Seventy-seven first year students and 45 third year students took part in the study. All students were attending the university at the time of the study. None of the first year students had completed any clinical placement hours, and all of the third year students had completed the required number of clinical hours for a physiotherapy degree.
The narrative vignette consisted of nine questions relating to the vignette. Thematic content analysis was applied to the results.
The role of experience appeared to influence students' responses. The third year students' reactions to each narrative appeared more consistent and unified as a medical voice. This appeared to support their preference for an ideal type of story and patient. Problems with each narrative were identified, although often not critiqued.
Students need more time to consider different illness narratives in order to accept and understand them.
... One of these was well versed in qualitative research and was familiar with theories of hope (BS), and the other was an experienced qualitative research physiotherapist (CML). The role of these two colleagues was to act as ''critical friends'' (Melia, 2000; Norris, 1997) and provide a theoretical sounding board to encourage reflection upon, and exploration of, alternative explanations and interpretations as they emerged in relation to the data. As part of this dialogic process, AS was required to make a defendable case, that the available data supported his categorization of themes. ...
Drawing on data from a qualitative study of a small group of physiotherapists, this article explores the meaning of hope in neurological physiotherapy practice. Nine female physiotherapists (43.2 +/- 8.5 years) each took part in a one-off semistructured interview. The most common kinds of hope used and offered by the physiotherapists in the process of working with people with neurological disease were evident in five themes. These are termed 1) Realistic Hope, 2) False Hope, 3) Accepting Hope and No Need to Hope, 4) Hope in Faith, and 5) No Hope. Neurological experience with patients in physiotherapy provides stories that relate to hope and this informs the way they understand it. It is important that when considering therapeutic outcome, the physiotherapists recognised the need for having a realistic hope and the danger of having a false hope. However, both were balanced with the need to accept that the unknown was possible and not limiting this or losing their dream. Where hope in relation to recovery was not possible, hope in other areas of life was emphasised. The implications of this dynamic process of working with different kinds of hope in relation to people with neurological disease are considered.
Background
A range of innovative performance analysis metrics have been applied in recent years to investigate aspects of football using tempo-spatial and network analyses. These approaches have gained traction within some professional teams to quantify and assess features of collective behaviour. However, metrics employed are rarely created from, or clearly link to, domain expertise and as a result coaches may be hesitant of their value. Therefore, the aim of this study was to identify coach perceptions of spatial temporal and network metrics and identify the feasibility of an iterative and collaborative process to developing metrics.
Methods
Two rounds of semi-structured interviews were conducted with three Scottish youth international UEFA Pro License coaches (age: 47.0 ± 2.7 years) with a focus on aligning metrics with concepts and principles of play. An iterative approach was used centring around spatial-temporal and network metrics and their adaptation. Reflexive thematic analyses were conducted with final metrics categorized as resonant (accurately describing concept or principles of play), relevant (appropriate but with limitations that need improvement), or hesitant (skeptical of usefulness).
Results
Across the ten recognized principles of play, nine metrics were identified and adapted to varying degrees. Resonant metrics included: network intensity (mobility), distance between defenders (discipline), triangles (support), team length and distance between deepest defender and goal line (depth).
Conclusion
Coaches recognize principles of play within complex collective behaviour metrics and should be encouraged to collaborate with analysts to develop support systems that may prove to be more valuable and usable.
Knowledge discourses and students views
Over the decades trends in clinical skills education have swung between classroom based simulation and clinical based experience. Furthermore with the development of new roles such as the Advanced Nurse Practitioner, clinical skills which were previously the domain of one profession are now taught across professions. However little research has been undertaken which explores the perceptions of those involved in different educational strategies or the factors which influence those perceptions. This book explores the perceptions of those involved in two types of clinical skills education for the role of nurse practitioner. The history of the role is traced and an analysis of the perceptions expressed over the course of an educational initiative undertaken. Perceptions are clearly linked to wider knowledge discourses and a model of discourse positioning and movement developed. The study raises issues for research, education, and practice, and informs contemporary debates regarding educational evaluation and the theory-practice gap. The book should be useful to a range of health care professionals, educationalists, researchers and those interested in knowledge translation.
Introduction:
Occupational asthma (OA) accounts for one in six cases of adult-onset asthma and is associated with a large societal cost. Many cases of OA are missed or delayed, leading to ongoing exposure to the causative agent and avoidable lung function loss and poor employment-related outcomes. Enquiry about work-related symptoms and the nature of work by healthcare professionals (HCPs) is limited, evident in primary and secondary care. Potential reasons cited for this are time pressure, lack of expertise and poor access to specialists.
Aim:
To understand organisational factors and beliefs and behaviours among primary HCPs that may present barriers to identifying OA.
Methods:
We employed a qualitative phenomenological methodology and undertook 20-45 min interviews with primary HCPs in West Midlands, UK. We used purposive and snowball sampling to include general practitioners (GPs) and practice nurses with a range of experience, from urban and rural settings. Interviews were recorded digitally and transcribed professionally for analysis. Data were coded by hand, and thematic analysis was undertaken and determined theoretically until themes were saturated.
Results:
Eleven HCPs participated (eight GPs, three nurses). Four themes were identified that were considered to impact on identification of OA: (1) training and experience, (2) perceptions and beliefs, (3) systems constraints, and (4) variation in individual practice. OA-specific education had been inadequate at every stage of training and practice, and clinical exposure to OA had been generally limited. OA-specific beliefs varied, as did clinical behaviour with working-age individuals with asthma. There was a focus on diagnosis and treatment rather than attributing causation. Identified issues regarding organisation of asthma care were time constraints, lack of continuity, referral pressure, use of guidelines and templates, and external targets.
Conclusion:
Organisation and delivery of primary asthma care, negative OA-related beliefs, lack of formal education, and exposure to OA may all currently inhibit its identification.
Background: This study was initiated because the author noted that a large number of patients with diabetes attending a vascular orthotic clinic were not wearing the orthotic devices they had been prescribed and this was having detrimental effects on their health. A literature search found that there was very little evidence to explain why patients choose not to wear such devices. The evidence available was quantitative, which may have prevented patients from discussing their opinions. Objectives: The aim of this study was to explore the experiences of adults with diabetes regarding the prescription and wearing of orthotic devices to better understand why some patients chose not wear them. Methods: Participants were interviewed using semi-structured interviews. These interviews were taped, transcribed and analysed by the author and a number of themes and categories were identified. Results: The themes that emerged included the patients' past experiences, experiences of the clinic, problems associated with their footwear, beliefs and motivations, compliance, and coping strategies. Conclusions: The findings have a number of implications for the care of people with diabetic foot disease. These include the need to assess and treat patients holistically, to develop trusting and open patient-practitioner relationships, and to use strategies to help patients adapt to their circumstances. Conflict of interest: None Abstract
Background:
Despite their movement difficulties, youngsters with Developmental Co-ordination Disorder (DCD) generally have sufficient capability for physical activity. However, they tend to be less physically active and less physically fit than their well co-ordinated age peers. The aim of this study was to use qualitative research methods to understand which factors constrain and facilitate participation in physical activity in teenagers with DCD, in order to help inform future health promotion programmes.
Method:
Semi-structured interviews were conducted with eight teenagers with DCD (aged 13-15) and their parents. The interviews focused on how much physical activity was typically undertaken by the child and the perceived constraints and facilitators to being physically active. Interviews were transcribed and subjected to categorical-content analysis.
Results:
Half of the children and all but one of the parents reported that the children did little physical activity. Although most children disliked competitive team games, they reported many physical activities that they did enjoy and they reported wanting to be more physically active. Perceived internal constraints to participation included poor motor skill, lack of motivation and reports of fatiguing easily. Perceived external constraints included difficulty travelling to activities, negative comments from peers and teachers' lack of understanding of DCD.
Conclusions:
Reports of low levels of physical activity support previous literature and are a cause for concern for this group. The teenagers expressed the desire to be more active, yet the interviews revealed both personal and environmental constraints to engagement in physical activity. It is clear that these factors interact in a dynamic way and that teachers, schools and communities play an important role in creating a motivational environment for youngsters with DCD to engage in physical activity and learn to maintain an active lifestyle as they move into adulthood.
This study set out to answer the following questions. What influences a junior doctor's response to a judgement call within a clinical setting? What, if any, are the relationships between these influences?
This paper describes an interpretivist study based on a grounded theory approach to data analysis. This involved a phased approach to data collection using semi-structured interviews. Analysis was facilitated by observations and group presentations. Participants were doctors in their first year of postgraduate practice who were purposively selected from a range of hospitals in the Northern Deanery.
The data demonstrated a number of influences on whether junior doctors chose to seek senior assistance. These included the upholding and balancing of tenets that were necessary for ensuring safe practice, and estimating the chance and severity of potential negative consequences to patients, themselves and their teams. In order to make these judgements, junior doctors drew on different forms of knowledge, especially knowledge gained from previous clinical experiences. In judging whether or not to contact a senior, pre-registration house officers (PRHOs) were practising essential clinical attributes, that of independent yet co-operative and discerning practitioners who are able to balance multiple considerations while ensuring patient care.
This particular judgement of risk, as it was described by those interviewed, was a dynamic process exemplified by the need to create counterbalances between multiple consequences. As a result, no prescriptive action could have allowed PRHOs to deal with the numerous configurations they faced and took into account.
The experience of being critically ill and being a patient in a critical care unit has attracted considerable research interest in recent years. Evidence of this is apparent in the increasing development of critical care follow-up services in many of our hospitals in the United Kingdom. However, actually conducting research this area can be fraught with difficulties and problems. Research participants may be extremely vulnerable during their recovery, making the methodological considerations crucial, in any study, which aims to explore the experiences of survivors. This paper explores some of the difficulties the researcher can face when researching this area.